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home:diseases:anemia [08.12.2019] – [Introduction] sallieqhome:diseases:anemia [09.14.2022] (current) – external edit 127.0.0.1
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 ====== Anemia ====== ====== Anemia ======
  
-<relatedarticles> [[home:diseases:cfs|Chronic fatigue syndrome]],  [[home:diseases:pernicious_anemia|Pernicious anemia]]</article>+<relatedarticles> [[home:diseases:cfs|Chronic fatigue syndrome]],  [[home:othertreatments:othertreatments|Thyroid hormone and mineral supplementation]], [[home:diseases:pernicious_anemia|Pernicious anemia]]</article>
  
-Anemia of chronic disease, also referred to as anemia of inflammatory response, is a common condition seen in chronic illness.(({{pubmed>long:7719246}})) Anemia is not due to iron deficiency, nor will it be helped by iron supplements. In fact, iron supplements are counterproductive because iron is "crucial" to the survival and multiplication of pathogens.(({{pubmed>long:21414421}}))+Anemia of chronic disease, also referred to as anemia of inflammatory response, is a common condition seen in chronic illness.(({{pmid>long:7719246}})) Anemia is not due to iron deficiency, nor will it be helped by iron supplements. In fact, iron supplements are counterproductive because iron is "crucial" to the survival and multiplication of pathogens.(({{pmid>long:21414421}}))
  
 Standard measures of iron status, such as ferritin, total iron-binding capacity, and serum iron are directly affected by chronic disease. In contrast, soluble transferrin receptor (sTfR) is elevated in iron deficiency but is not appreciably affected by chronic disease. Standard measures of iron status, such as ferritin, total iron-binding capacity, and serum iron are directly affected by chronic disease. In contrast, soluble transferrin receptor (sTfR) is elevated in iron deficiency but is not appreciably affected by chronic disease.
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 <blockquote>Excessive and misplaced iron promotes an array of neurodegenerative and endocrine diseases as well as cardiomyopathy, arthropathy, neoplasia and infection. Vertebrates maintain an iron withholding defense system designed to prevent accumulation of redox-active (free) iron in sensitive sites and to sequester the metal in innocuous packages. <blockquote>Excessive and misplaced iron promotes an array of neurodegenerative and endocrine diseases as well as cardiomyopathy, arthropathy, neoplasia and infection. Vertebrates maintain an iron withholding defense system designed to prevent accumulation of redox-active (free) iron in sensitive sites and to sequester the metal in innocuous packages.
  
-//**Eugene D. Weinberg**, "Iron Withholding: A Defense Against Disease"//(({{pubmed>long:18487852}}))</blockquote> +//**Eugene D. Weinberg**, "Iron Withholding: A Defense Against Disease"//(({{pmid>long:18487852}}))</blockquote> 
  
  
-The low levels of blood cells characteristic of anemia of chronic disease (ACD) are relatively common among autoimmune conditions(({{pubmed>long:18695181}})) and obesity.(({{pubmed>long:17766530}})) A related hallmark of ACD is increased uptake and retention of iron within cells.(({{pubmed>long:15758012}})) For many physicians, ACD should be treated as a cause of illness, but the condition serves to protect the host against further infection including those that may drive autoimmune processes. In their //New England Journal of Medicine// review, Weiss and Goodnough write that despite treatment guidelines, “anemia of chronic disease remains underrecognized and undertreated.” Anemia should be actively managed, they put forth, because the condition “has been associated with a relatively poor prognosis” and is associated with suboptimal oxygen delivery.(({{pubmed>long:15758012}}))+The low levels of blood cells characteristic of anemia of chronic disease (ACD) are relatively common among autoimmune conditions(({{pmid>long:18695181}})) and obesity.(({{pmid>long:17766530}})) A related hallmark of ACD is increased uptake and retention of iron within cells.(({{pmid>long:15758012}})) For many physicians, ACD should be treated as a cause of illness, but the condition serves to protect the host against further infection including those that may drive autoimmune processes. In their //New England Journal of Medicine// review, Weiss and Goodnough write that despite treatment guidelines, “anemia of chronic disease remains underrecognized and undertreated.” Anemia should be actively managed, they put forth, because the condition “has been associated with a relatively poor prognosis” and is associated with suboptimal oxygen delivery.(({{pmid>long:15758012}}))
  
-However, Zarychanski and Houston state ACD is fundamentally an adaptive physiologic response which benefits the patient during times of infection(({{pubmed>long:18695181}})) with Baker and Ghio offering a similar argument.(({{pubmed>long:19628641}})) As a nutrient that is essential for the function of many microbes, increased iron availability promotes microbial growth.(({{pubmed>long:1560730}})) For example, //Mycobacteria// synthesize molecules that have several times higher affinity for iron than their host counterparts, they also synthesize molecules for efficient storage of excess iron.(({{pubmed>long: 21414421}})) Further, moderation of iron inside a host is a threat to mycobacterial persistence.+However, Zarychanski and Houston state ACD is fundamentally an adaptive physiologic response which benefits the patient during times of infection(({{pmid>long:18695181}})) with Baker and Ghio offering a similar argument.(({{pmid>long:19628641}})) As a nutrient that is essential for the function of many microbes, increased iron availability promotes microbial growth.(({{pmid>long:1560730}})) For example, //Mycobacteria// synthesize molecules that have several times higher affinity for iron than their host counterparts, they also synthesize molecules for efficient storage of excess iron.(({{pmid>long: 21414421}})) Further, moderation of iron inside a host is a threat to mycobacterial persistence.
  
-Further, the ability of a particular species of bacteria to glean iron from its host is often a good indicator of its virulence. It is logical then that the body sequesters iron in response to an infection: Kemna et al. showed that injecting human volunteers with lipopolysaccharides, a component of the cell walls of gram-negative bacteria, leads to a significant decrease in serum iron.(({{pubmed>long:15886319}})) In iron-deficient conditions, blood plasma is moderately effective at inhibiting bacterial growth.(({{pubmed>long:1560730}})) (({{pubmed>long:15372409}})) (({{pubmed>long:1748112}}))+Further, the ability of a particular species of bacteria to glean iron from its host is often a good indicator of its virulence. It is logical then that the body sequesters iron in response to an infection: Kemna et al. showed that injecting human volunteers with lipopolysaccharides, a component of the cell walls of gram-negative bacteria, leads to a significant decrease in serum iron.(({{pmid>long:15886319}})) In iron-deficient conditions, blood plasma is moderately effective at inhibiting bacterial growth.(({{pmid>long:1560730}})) (({{pmid>long:15372409}})) (({{pmid>long:1748112}}))
  
 It might otherwise seem reasonable for a clinician to directly manage ACD using iron supplements or other antianemic therapies: fatigue and shortness of breath can be very unpleasant. However, administering this type of short-time palliation may lead to poorer outcomes. The possibility that ACD is an adaptive response by the host to microbes raises the specter that artificially resolving anemia subverts the immune response allowing microbes to spread by subverting the immune response and consequently allowing microbial infections to proliferate, thus, making the question of what ultimately causes autoimmune diseases all the more urgent. It might otherwise seem reasonable for a clinician to directly manage ACD using iron supplements or other antianemic therapies: fatigue and shortness of breath can be very unpleasant. However, administering this type of short-time palliation may lead to poorer outcomes. The possibility that ACD is an adaptive response by the host to microbes raises the specter that artificially resolving anemia subverts the immune response allowing microbes to spread by subverting the immune response and consequently allowing microbial infections to proliferate, thus, making the question of what ultimately causes autoimmune diseases all the more urgent.
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 ===== Tests ===== ===== Tests =====
  
-  * **serum ferritin** – The protein in the blood that stores iron for later use by the body. Serum ferritin is also an acute phase reactant and will rise rapidly in the face of inflammation. May be high in anemia of chronic disease, especially if the liver is involved. Macrophages, a type of phagocyte, are the cells responsible for accreting ferritin. Described further [[http://www.labtestsonline.org/understanding/analytes/ferritin/test.html|here]]. +  * **serum ferritin** – The protein in the blood that stores iron for later use by the body. Serum ferritin is also an acute phase reactant and will rise rapidly in the face of inflammation. May be high in anemia of chronic disease, especially if the liver is involved. Macrophages, a type of phagocyte, are the cells responsible for accreting ferritin. Described further [[https://www.labtestsonline.org/understanding/analytes/ferritin/test.html|here]]. 
-  * **serum iron** – The amount of iron being carried by transferrin in the blood plasma. On its own, serum iron  provides no useful information. Serum iron has a diurnal variation that can be as much as 30% within a single individual. It is sensitive to the day's dietary iron intake and is affected by all the confounding diseases listed above. A low serum iron picked up as an incidental finding has a very low specificity for iron deficiency. Described further [[http://www.labtestsonline.org/understanding/analytes/serum_iron/test.html|here]]. +  * **serum iron** – The amount of iron being carried by transferrin in the blood plasma. On its own, serum iron  provides no useful information. Serum iron has a diurnal variation that can be as much as 30% within a single individual. It is sensitive to the day's dietary iron intake and is affected by all the confounding diseases listed above. A low serum iron picked up as an incidental finding has a very low specificity for iron deficiency. Described further [[https://www.labtestsonline.org/understanding/analytes/serum_iron/test.html|here]]. 
-  * **total iron binding capacity (TIBC)** – Shows if there is the "right amount" of iron in the blood. TIBC helps measure the ability of transferrin to carry iron in the blood. TIBC is typically measured along with serum iron to evaluate people suspected of having either iron deficiency or iron overload. The iron concentration divided by TIBC gives the transferrin saturation, which is a more useful indicator of iron status than iron or TIBC alone. The TIBC test measures the amount of iron that the blood would carry if the transferrin were fully saturated. Since transferrin is produced by the liver, the TIBC can be used to monitor liver function and nutrition. Described further [[http://www.labtestsonline.org/understanding/analytes/tibc/test.html|here]].+  * **total iron binding capacity (TIBC)** – Shows if there is the "right amount" of iron in the blood. TIBC helps measure the ability of transferrin to carry iron in the blood. TIBC is typically measured along with serum iron to evaluate people suspected of having either iron deficiency or iron overload. The iron concentration divided by TIBC gives the transferrin saturation, which is a more useful indicator of iron status than iron or TIBC alone. The TIBC test measures the amount of iron that the blood would carry if the transferrin were fully saturated. Since transferrin is produced by the liver, the TIBC can be used to monitor liver function and nutrition. Described further [[https://www.labtestsonline.org/understanding/analytes/tibc/test.html|here]].
   * **soluble transferrin receptor (sTfR)** – Relatively new test. While standard measures of iron status such as ferritin, total iron-binding capacity, and serum iron are directly affected by chronic disease sTfR is elevated in iron deficiency but is not appreciably affected by chronic disease. A good way to verify anemia of chronic desease because it is not affected by inflammation. Should be considered for anemic patients whose differential diagnosis includes iron deficiency and anemia of inflammatory disease.    * **soluble transferrin receptor (sTfR)** – Relatively new test. While standard measures of iron status such as ferritin, total iron-binding capacity, and serum iron are directly affected by chronic disease sTfR is elevated in iron deficiency but is not appreciably affected by chronic disease. A good way to verify anemia of chronic desease because it is not affected by inflammation. Should be considered for anemic patients whose differential diagnosis includes iron deficiency and anemia of inflammatory disease. 
   * **hemoglobin  (HGB)** – The iron-containing oxygen-transport metalloprotein in the red blood cells of all vertebrates. The effect of locking up iron stores is to reduce the ability of the bone marrow to produce red blood cells. These cells require iron for their massive amounts of hemoglobin which allow them to transport oxygen.   * **hemoglobin  (HGB)** – The iron-containing oxygen-transport metalloprotein in the red blood cells of all vertebrates. The effect of locking up iron stores is to reduce the ability of the bone marrow to produce red blood cells. These cells require iron for their massive amounts of hemoglobin which allow them to transport oxygen.
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 Male and females patients whose HGB falls to 11 and/or whose HCT falls to 28, should work with their doctors to [[home:mp:managing_immunopathology|slow down their immune response]]. Changes may be evident in as soon as several weeks. It may take [[home:patients:mp_duration|several years]] for anemia blood markers to return to a normal range.  Doctors should use their judgement regarding the frequency of testing to monitor anemia. Male and females patients whose HGB falls to 11 and/or whose HCT falls to 28, should work with their doctors to [[home:mp:managing_immunopathology|slow down their immune response]]. Changes may be evident in as soon as several weeks. It may take [[home:patients:mp_duration|several years]] for anemia blood markers to return to a normal range.  Doctors should use their judgement regarding the frequency of testing to monitor anemia.
  
 +===== Patients experiences =====
  
 +<blockquote>
 +My red blood count has risen into the normal range without any kind of iron or vitamin supplemenation.
 +
 +//**NorCalJim** in phase 3// </blockquote>
 +
 +<blockquote>
 +When I was diagnosed with hypothyroidism (from Hashimoto's thyroiditis) I had iron-deficiency anaemia.  Doctor ordered me to take iron supplements for a month before he even gave me any thyroxine. BIG mistake. (Not his fault, but had we only known about the MP...) My iron levels came up, yes, I guess because I was ingesting enough to feed myself and all those iron-hungry bacteria!  The awful part was I felt more fatigued than ever before and my arthritic joints hurt more than ever before. I was depressed, in pain and had to give up my work as a massage therapist after 25 years.
 +
 +Once I started thyroxine my life turned around, as I got most of my energy back and my thinning hair started growing back - but my arthritis was as bad as ever.
 +
 +Fast forward 1 year - I found the MP and began phase one. Within days of starting mino I began to experience a metallic taste in my mouth. Could that metallic taste be ... metal?  Can't prove it, but my ferritin levels shot through the roof! You can read my posts on my thread:  https://www.marshallprotocol.com/forum35/7698.html
 +
 +I reckon all those iron-sequestering CWD monsters were dying and giving up all the iron back into my bloodstream. After a couple of months, my ferritin levels came down to normal again and the metallic taste went away at the same time.
 +
 +So there you have it.
 +
 +//**Claudia**, MarshallProtocol.com// </blockquote>
  
 ===== Other treatments ===== ===== Other treatments =====
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 Doctors using these drugs are advised "to maintain the lowest hemoglobin level consistent with avoiding the need for transfusions." It isn't necessary to maintain a normal HGB and HCT while patients are recovering on the MP. Doctors using these drugs are advised "to maintain the lowest hemoglobin level consistent with avoiding the need for transfusions." It isn't necessary to maintain a normal HGB and HCT while patients are recovering on the MP.
  
-A randomized controlled trial of critically ill patients showed erythropoiesis-stimulating agents did not reduce overall mortality.(({{pubmed>long:17804841}}))+A randomized controlled trial of critically ill patients showed erythropoiesis-stimulating agents did not reduce overall mortality.(({{pmid>long:17804841}}))
  
  
 ===== Epidemiological studies ===== ===== Epidemiological studies =====
  
-In a 10 year follow up study from Chile, infants who already had high levels of hemoglobin proteins in their blood and were fed iron-fortified formula [[http://www.reuters.com/article/2011/11/12/us-iron-babies-idUSTRE7AB02820111112|ended up with lower scores on tests of thinking and memory]] than those given low-iron formula.(({{pubmed>long:22064877}})) +In a 10 year follow up study from Chile, infants who already had high levels of hemoglobin proteins in their blood and were fed iron-fortified formula [[https://www.reuters.com/article/2011/11/12/us-iron-babies-idUSTRE7AB02820111112|ended up with lower scores on tests of thinking and memory]] than those given low-iron formula.(({{pmid>long:22064877}}))
- +
- +
-===== Patients experiences ===== +
- +
-<blockquote> +
-My red blood count has risen into the normal range without any kind of iron or vitamin supplemenation. +
- +
-//**NorCalJim** in phase 3// </blockquote> +
- +
-<blockquote> +
-When I was diagnosed with hypothyroidism (from Hashimoto's thyroiditis) I had iron-deficiency anaemia.  Doctor ordered me to take iron supplements for a month before he even gave me any thyroxine. BIG mistake. (Not his fault, but had we only known about the MP...) My iron levels came up, yes, I guess because I was ingesting enough to feed myself and all those iron-hungry bacteria!  The awful part was I felt more fatigued than ever before and my arthritic joints hurt more than ever before. I was depressed, in pain and had to give up my work as a massage therapist after 25 years. +
- +
-Once I started thyroxine my life turned around, as I got most of my energy back and my thinning hair started growing back - but my arthritis was as bad as ever. +
- +
-Fast forward 1 year - I found the MP and began phase one. Within days of starting mino I began to experience a metallic taste in my mouth. Could that metallic taste be ... metal?  Can't prove it, but my ferritin levels shot through the roof! You can read my posts on my thread:  https://www.marshallprotocol.com/forum35/7698.html +
- +
-I reckon all those iron-sequestering CWD monsters were dying and giving up all the iron back into my bloodstream. After a couple of months, my ferritin levels came down to normal again and the metallic taste went away at the same time. +
- +
-So there you have it. +
- +
-//**Claudia**, MarshallProtocol.com// </blockquote>+
  
  
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 {{tag>diseases}} {{tag>diseases}}
  
 +<nodisp>
 ===== Notes and comments ===== ===== Notes and comments =====
  
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   * Legacy content   * Legacy content
-    * [[http://www.marshallprotocol.com/forum32/3479.html]] +    * [[https://www.marshallprotocol.com/forum32/3479.html]] 
-    * [[http://www.marshallprotocol.com/view_topic.php?id=10090&forum_id=39&jump_to=135337]] +    * [[https://www.marshallprotocol.com/view_topic.php?id=10090&forum_id=39&jump_to=135337]] 
    
 Given iron’s role as a key microbial nutrient, it may be that patients receiving blood plasma have significantly increased mortality as was reported in a randomized controlled trial(9971864) and why an  Given iron’s role as a key microbial nutrient, it may be that patients receiving blood plasma have significantly increased mortality as was reported in a randomized controlled trial(9971864) and why an 
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-According to the textbook "An Introduction to Human Disease: Pathology and Pathophysiology Correlations" by Leonard V. Crowley,[[http://books.google.com/books?id=vnT6enWTnZoC&pg=PA357&lpg=PA357&dq=bone+marrow+suppression&source=web&ots=TRxz3MI3Aw&sig=DKx-gUq6L5NAQpS4D6tC0C7CMjk&hl=en#v=onepage&q=bone%20marrow%20suppression&f=false|Bone Marrow Suppression, Damage, or Infiltration]] "Many conditions may depress bone marrow functions. Chronic diseases of all types may impair hematopoiesis and lead to mild or moderate anemia, which is called the anemia of chronic disease. ... The most common cause of this type of anemia is chronic infection, but other chronic diseases and some malignant tumors may also be responsible."+According to the textbook "An Introduction to Human Disease: Pathology and Pathophysiology Correlations" by Leonard V. Crowley,[[https://books.google.com/books?id=vnT6enWTnZoC&pg=PA357&lpg=PA357&dq=bone+marrow+suppression&source=web&ots=TRxz3MI3Aw&sig=DKx-gUq6L5NAQpS4D6tC0C7CMjk&hl=en#v=onepage&q=bone%20marrow%20suppression&f=false|Bone Marrow Suppression, Damage, or Infiltration]] "Many conditions may depress bone marrow functions. Chronic diseases of all types may impair hematopoiesis and lead to mild or moderate anemia, which is called the anemia of chronic disease. ... The most common cause of this type of anemia is chronic infection, but other chronic diseases and some malignant tumors may also be responsible."
  
  
 GI bleeding GI bleeding
  
-A simple outpatient two minute check of your stool for blood would rule out your doctor's concerns pertaining to bleeding into the gut.[[http://www.nlm.nih.gov/medlineplus/ency/article/007008.htm|NIH: Fecal occult blood test]]+A simple outpatient two minute check of your stool for blood would rule out your doctor's concerns pertaining to bleeding into the gut.[[https://www.nlm.nih.gov/medlineplus/ency/article/007008.htm|NIH: Fecal occult blood test]]
  
  
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 Lowering olmesartan might improve the RBC levels but at the cost increasing the anoxia and and impeding the healing in the kidneys. Lowering olmesartan might improve the RBC levels but at the cost increasing the anoxia and and impeding the healing in the kidneys.
  
-for reference links, see full [[http://marshallprotocol.com/view_topic.php?id=7525&forum_id=35&jump_to=227096#p227096|post by Jigsaw]]</blockquote> +for reference links, see full [[https://marshallprotocol.com/view_topic.php?id=7525&forum_id=35&jump_to=227096#p227096|post by Jigsaw]]</blockquote> 
-===== References =====+===== References =====</nodisp> 
home/diseases/anemia.1565648295.txt.gz · Last modified: 08.12.2019 by sallieq
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